Gascó José, González-Herranz Pedro, Minguez Mari-Fé, Gil-Albarova Raúl
Departamento de Cirugía, Facultad de Medicina, Hospital Clínico Universitario, Valencia, Spain.
J Pediatr Orthop B. 2010 Jul;19(4):361-5. doi: 10.1097/BPB.0b013e3283395f5a.
The authors present two cases of necrosis of the distal tibial epiphysis without evidence of trauma in either of the patients. One patient after a long follow-up showed a Charcot arthropathy. In contrast, the second patient recovered distal epiphysis ad integrum. Close follow-up and ankle protection with an orthosis may be necessary to spare the joint and prevent significant damage. The authors highlight the difficulty in diagnosing these special cases in which pain, a common finding in orthopaedics, is not present.
IV.
作者报告了两例胫骨远端骨骺坏死病例，两名患者均无创伤证据。一名患者经过长期随访出现了夏科氏关节病。相比之下，第二名患者的远端骨骺完全恢复。密切随访并用矫形器保护踝关节可能有必要，以保护关节并防止严重损伤。作者强调了诊断这些特殊病例的困难，因为在骨科常见的疼痛症状并不存在。
IV级。
